Is It Common NOT to Do Muscle Tightening with a Tummy Tuck? (Photos)

I'm 38 yrs old. 5'3 and 140 lbs and a parent of 2. I'm scheduled for a tummy tuck at the end of this week to correct my pooch left over from my c-section. My doctor told me that my core is strong and won't require muscle tightening. Is that common? Why would he not tighten my muscles if it's a part of the procedure. I figured if i am paying for it, why skip the most important step? Am i wrong?

Doctor Answers 19

Tummy tuck without muscle tightening

There are three things that can detract from a perfectly flat tummy. 

  • abdominal wall laxity or " looseness" caused by stretching due usually to pregnancy or less often massive weight gain and loss. 
  • skin laxity and looseness due to similar causes as mentioned above
  • excess fat

A patient needs muscle tightening only if the abdominal wall muscles are loose. If the muscles and abdominal wall are adequate then "skin only abdominoplasty" is usually all that is needed. The advantage of not performing muscle tightening is that there is much less pain and recovery. Therefore, skin only abdominoplasty is a great choice for patients who have adequate abdominal wall contour and/or those who want to minimize the pain and downside of the procedure. 

I agree with other physicians who stress a consult with your plastic surgeon to discuss your particular wishes. 

Dallas Plastic Surgeon
4.6 out of 5 stars 47 reviews

Tighten or not to tighten the muscles in a TT, that is the question

Thank you for the photos. First of all I hope you consulted with a board certified plastic surgeon. Looking at you photos, I would definitely do a muscle plication and liposuction of you flanks and hips. The fee quoted to you might not have the muscle tightening in it. You should clear this up prior to your scheduled surgery or seek another opinion. You do not want to have two surgeries instead of one performed appropriately. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Must have muscle repair

Thanks for the picture.  A muscle repair is essential for you because ofthe diastasis of your muscles that I can see on your pictures.  I feel you will be dissapointed without it.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 201 reviews

Muscle Tightening with a Tummy Tuck

In patients that have had only one or two children and that are young and athletic, sometimes they don’t have a diastasis rectus and don’t need tightening of the muscles. Most of the time, more than 90%, patients will need diastasis rectus muscle tightening because there is a widening or laxity of this area from pregnancy.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 64 reviews

Muscle tightening during tummy tuck

Muscle tightening is routinely part of every abdominoplasty. It would be very rare not to need tightening of the muscles, especially after child bearing.

Donna Rich, MD
Webster Plastic Surgeon
4.5 out of 5 stars 33 reviews

Muscle Tightening and The Tummy Tuck Procedure

Great question! Every surgeon operates differently so if you are concerned I advise you to get a second opinion from a board certified plastic surgeon.

Although examining a patient in person is much more efficient, from the looks of your photos and given the fact that you are a mother of two, I believe that a combo of muscle tightening and liposuction of your hips, flanks and abdomen would be suitable for you.

Post pregnancy a woman’s body goes through many changes, and one significant change that typically happens is that the muscle wall is weakened and no amount of exercise and dieting can repair the muscle separation. In some cases patients do not need it, but in your case I do think a second opinion so that you feel more comfortable with the procedure is a great idea. You can also call your surgeon’s office and express your concern. Your surgeon is there to do what is best for you and it’s your duty as a patient to express what you want so your surgeon can meet your needs.

To learn more, please visit our page on tummy tuck surgery.

Siamak Agha, MD, PhD, FACS
Orange County Plastic Surgeon
4.7 out of 5 stars 106 reviews

Muscle Tightening During Tummy Tuck

Given that you have had two children, it is likely that you would benefit from muscle tightening.  It appears on the side view, that you have some convexity of your abdomen.  Muscle plication would probably help this.  You should make sure that you and your surgeon are on the same page about this. Also make sure that he is a Board Certified plastic surgeon.  

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 99 reviews

Muscle tightening during an abdominoplasty

It is rare that I do not tighten the abdominal muscles during an abdominoplasty.  You have had two children and your photos show that you have some abdominal protuberance that could be improved with muscle plication.  Women's habits change over a lifetime and although you are exercising now chances are that you will not always be doing so ( I speak from personal experience).  This is your opportunity to have those muscles brought together forever.  Why skip over it?  You obviously asked the surgeon you saw why he wouldn't do it for you and you were smart to do so.  There seems to be overwhelming disagreement  among the posters here.  Perhaps you should consider getting the opinion of another board certified plastic surgeon in your area.  Make sure the surgeon you choose is certified by the American Board of Plastic Surgery and not some other board that sounds similar.  Good Luck!

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 28 reviews

Is It Common NOT to Do Muscle Tightening with a Tummy Tuck? (Photos)

The majority of the expert posters feel some form of muscle tightening is the better option. Maybe you and your chosen doctor need further discussions to clear the air. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Tummy tuck without muscle tightening

Thanks for including photos - they're quite revealing. The generalized convexity of your abdominal wall is likely the result of separation of your rectus abdominus muscle (i.e. the muscles tightened during a tummy tuck). Performing a tummy tuck without tightening these muscles likely means that this shape of your abdominal wall will persist.

It's important that you and your plastic surgeon are on the same page prior to surgery. If you have questions, ask him - he may have a very good reason.

Sam Jejurikar, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 95 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.